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BACKGROUND: Alcohol intoxication in pediatric trauma is underappreciated. The aim of this study was to characterize alcohol screening rates in pediatric trauma METHODS: The Los Angeles County Trauma System Database was queried for all patients aged < 18 years who required admission between 2003 and 2008. Patients were compared by age and gender. RESULTS: A total of 18,598 patients met the inclusion criteria; 4,899 (26.3%) underwent blood alcohol screening, and 2,797 (57.1%) of those screened positive. Screening increased with age (3.3% for 0-9 years, 15.1% for 10-14 years, and 45.4% for 15-18 years; P < .01), as did alcohol intoxication (1.9% for 0-9 years, 5.8% 10-14 years, and 27.3% for 15-18 years; P < .01). Male gender predicted higher mortality in those aged 15 to 18 years (adjusted odds ratio, 1.7; P < .01), while alcohol intoxication did not (adjusted odds ratio, .97; P = .84). CONCLUSIONS: Alcohol intoxication is common in adolescent trauma patients. Screening is en-couraged for pediatric trauma patients aged >10 years who require admission. [ABSTRACT FROM AUTHOR]